Rendimiento Clínico de las Restauraciones Adhesivas con Resina Compuesta en Casos de Pacientes con Desgaste Severo e Incremento de Dimensión Vertical: Revisión de Literatura Sistematizada / Clínical Performance of Adhesive Restorations with Composite Resin in Cases of Patients with Severe Wear and Increased Vertical Dimension: Systematized Literature Review

El desgaste dental severo se describe como la pérdida sustancial de la estructura dental, con exposición de la dentina y pérdida significativa de igual o más de 1/3 de la corona clínica. El uso de materiales compuestos de resina permite al clínico ser más conservador, debido a su aplicación mínimamente invasiva. Además de ello, son relativamente económicas, proporcionan buena estética general, así como un buen rendimiento y facilidad en la reparación. El objetivo de esta revisión de literatura sistematizada es recopilar información disponible en la literatura referente a cuál es el rendimiento clínico de las restauraciones adhesivas con resina compuesta en casos de pacientes con desgaste severo e incremento de la dimensión vertical como objetivo rehabilitador. Se analizaron artículos entre los años 2000 y 2022, seleccionando cuatro bases de datos (Pubmed, Scopus, Scielo y Web of Science). Para identificar los descriptores se utilizó los Medical subject headings (Mesh): Tooth Wear, Composite Restorations, Resin y Oral Rehabilitation. No se aplicó restricciones de idioma, país de origen, autor o lugar de publicación donde se realizó el estudio. Como resultado de la búsqueda se obtuvieron 71 artículos, de los cuales se seleccionaron 5 que cumplieron con los criterios de elegibilidad para ser considerados en la revisión de literatura sistematizada. Se encontró un promedio de tasa de éxito ente el 89,4 % - 100 % en un promedio total de 5.2 años de seguimiento. Se puede concluir, hasta donde se tiene conocimiento en la literatura científica disponible, que el tratamiento de restauraciones adhesivas con resinas compuestas en pacientes con desgaste severo es recomendable, enfocado en un periodo a corto-mediano plazo (3-5 años), siendo una opción de tratamiento económica y mínimamente invasiva.

Severe tooth wear is described as the substantial loss of tooth structure, with dentin exposure and significant loss of equal to or more than 1/3 of the clinical crown. The use of resin composite materials allows the clinician to be more conservative, due to its minimally invasive application. In addition to this, they are relatively inexpensive, provide good general aesthetics, as well as good performance and ease of repair. The objective of this systematic literature review is to collect information available in the literature regarding the clinical performance of adhesive restorations with composite resin in cases of patients with severe wear and increase in the vertical dimension as a rehabilitation objective. Articles between the years 2000 and 2022 were analyzed, selecting four databases (Pubmed, Scopus, Scielo and Web of Science). To identify the descriptors, the Medical subject headings (Mesh) were used: Tooth Wear, Composite Restorations, Resin and Oral Rehabilitation. No language, country of origin, author or place of publication restrictions where the study was conducted were applied. As a result of the search, 71 articles were obtained, of which 5 were selected that met the eligibility criteria to be considered in the systematic literature review. An average success rate between 89.4 % - 100 % was found in a total average of 5.2 years of follow-up. It can be concluded, to the best of our knowledge in the available scientific literature, that the treatment of adhesive restorations with composite resins in patients with severe wear is recommendable, focused on a short-medium term period (3-5 years), being a Inexpensive and minimally invasive treatment option.

Estética do sorriso: Planejamento digital, cirurgia periodontal e procedimento restaurador / Smile's esthetics: digital smile design, periodontal surgery and restorative procedure

A busca pela estética tem acentuado a procura dos pacientes pela transformação do sorriso. Com o auxílio da fotografia e da tecnologia computacional, é possível a realização do DSD (digital smile design ­ planejamento digital do sorriso), que nos dá maior previsibilidade do tratamento. A confirmação deste planejamento digital se dá na prova do mock-up, a partir do qual o paciente tem a real sensação do seu sorriso planejado. Este artigo apresentou um caso clínico no qual se destaca a adesão do paciente ao tratamento e a realização de cirurgia periodontal para aumento de coroa clínica, seguida de restaurações diretas com resinas compostas, posterior ao enceramento diagnóstico. Com o planejamento integrando a terapia cirúrgica periodontal e o protocolo restaurador adesivo direto guiado por planejamento digital (DSD), foi possível estabelecer um excelente resultado com uma elevada satisfação do paciente.

The seek for esthetics has increased patient´s demand for the smile makeover. With the help of computational technology, it is possible to perform the DSD (digital smile design) with greater treatment predictability treatment. Confirmation of this digital planning occurs in the mock-up test, from which the patient has a physical sensation of his/her planned smile. This article presents a clinical case which highlights the patient cooperation and periodontal surgery for crown lengthening, followed by direct composite resin restorations after the diagnostic wax-up procedure. With an integrated treatment planning guided by the DSD protocol, it was possible to establish an excellent outcome with high patient satisfaction.

A Stereo Microscopic Evaluation of Microleakage - Laser Versus Visible Light Cured ClaSS V Composite Resin Restorations - An Invitro Study.

Composite resins are the most commonly used direct restorative materials in present day practice. Argon laser has been approved for photo polymerization of light Sensitive restorative materials. In this study a Comparative evaluation was made to assess the Marginal sealing ability of Visible light cured and argon laser cured class V Composite resin restorations. Occlusal and cervical areas were compared in degree of marginal leakage by giving separate scores for both the areas. Marginal leakage was higher in cervical margin than the occlusal margin in both the groups. A higher degree of marginal leakage was observed in laser cured restorations compared to the visible light cured restoration.

Restauraciones preventivas en resina como estrategia para control de la morfología dental / Preventive resin restorations as a strategy to control dental morphology

La morfología dental constituye uno de los agentes multicausales que contribuyen al desarrollo de la caries, en virtud a su capacidad de retener la placa dental y dificultar su remoción mediante las técnicas convencionales de higiene bucal. Bajo el enfoque preventivo de la odontología actual, los agentes selladores de resina han demostrado ser una herramienta eficaz que modifica el comportamiento de los rasgos morfológicos que configuran fosas y fisuras, por lo que su empleo dentro de los programas de promoción y prevención en salud bucal es masivo. No obstante el éxito clínico, aún existen fallas diagnósticas de odontólogos y auxiliares de higiene bucal, quienes no evalúan durante el diligenciamiento de la historia clínica el modo como se comporta la morfología dental, siendo esta altamente variable en cada uno de los individuos. En la presente revisión de literatura, dentro de los conceptos de la antropología dental, se describen los rasgos morfológicos dentales cuya expresión y variabilidad influyen en la retención de la placa dental, y se hace referencia a la eficacia de las restauraciones preventivas en resina en el control de la morfología dental como agente retenedor de placa dental

Dental morphology is one of multiple causative factors contributing to caries development, as it can be a dental plaque retention factor and it may difficult oral hygiene techniques. Under the preventive approach of actual dentistry, dental sealants have showed to be an effective tool to modify the retention characteristics of pits and fissures, and their use in promotion and prevention programs in oral health is massive. Despite clinical success of sealants application, there are still errors in diagnosis and lack of knowledge about dental morphology, which is highly variable among individuals. In this literature review are presented morphologic dental characteristics within the concepts of dental anthropology, describing their expression and variability as factors that influence dental plaque retention, and the role of preventive resin restorations in the control of dental morphology traits is also described